The Care Quality Commission
  • Care Home
  • Care home

Archived: Brook House

Overall: Good read more about inspection ratings

30 Berners Street, Lozells, Birmingham, West Midlands, B19 2DR (0121) 675 7079

Provided and run by:
Birmingham City Council

All Inspections

21 September 2016

During a routine inspection

The inspection took place on 21 and 22 September 2016 and was unannounced. We last inspected this service in May 2015 and found that the service required improvement. Most areas of improvement had been addressed, however further improvement was required in relation to how people’s care records were managed. The registered provider had implemented a new electronic records system which staff were learning to use.

Brook House is a residential care home for up to 14 adults who have a learning disability. The service offers people emergency care and short term breaks. At the time of our inspection, there were four people using the service. There was a registered manager in place who was present throughout our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People using the service and their relatives told us that they felt the service was safe. People were supported by staff who were aware of their needs and risks, and how to recognise and report abuse. Maintenance checks were completed routinely at the service and processes had been established to help staff keep people safe in the event of an emergency.

People received their medicines safely and as prescribed, however further areas of improvement were identified for how staff recorded the support that people received with their medicines.

People’s needs were met by supportive staff who received training and guidance for their roles. There were enough staff to meet people’s needs and people were protected by safe recruitment practices that had been improved by the registered provider.

People were able to move around the service freely and go to the community with the support of staff as they wished. People were encouraged to make their own decisions and were supported in line with the principles of the Mental Capacity Act (2005).

People were supported to eat sufficient foods of their choice with healthy options. People’s dietary requirements were met and their food and drink intake monitored as required, to reflect how these needs had been met. Staff supported people to access healthcare support and monitored their symptoms where required to help people stay well.

People were treated with respect and we saw that they had developed positive relationships with staff. Relatives confirmed that people were made to feel involved and welcome at the service.

People received care that was responsive to their needs. The registered manager sought feedback from people and relatives to ensure that people’s needs were met. People were supported to participate in activities of interest to them.

Relatives, staff and professionals spoke positively about the service and registered manager. Staff were motivated in their roles and felt that communication at the service was effective. People and relatives felt comfortable raising concerns and felt confident that issues would be addressed promptly. The registered manager reflected an understanding of their responsibilities and staff felt supported in their roles and able to share their ideas and concerns within an open, person-centred culture.

9 and 14 April 2015

During a routine inspection

The inspection took place on 9 and 14 April 2015 and was unannounced.

Brook House is a care home for up to 14 adults who have a learning disability. Emergency care and short term breaks are provided. One the first day of our inspection there were seven people staying at the home.

At the last inspection, in August 2014 we found that the provider had breached the Health and Social Care Act 2008 in relation to the care and welfare of people, safeguarding people from abuse, medicines, staffing, assessing and monitoring the quality of service provision and record keeping. Following that inspection we met with the provider and they sent us an action plan informing us of the action they would take to address the breaches we found. At this inspection we found that improvements had been made and that there were no breaches of regulation. Further improvement was needed to ensure people consistently received a good service.

Since our last inspection a new manager had been employed and had recently been registered. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People we spoke with told us they felt safe in the home and felt that the staff made sure they were kept safe. People were supported by sufficient numbers of staff who knew how to protect people from abuse. Medicines were being well managed and we found people were receiving their prescribed medicines at the correct time, in the correct dose. Care plans contained guidelines and risk assessments to provide staff with information that would protect people from harm but not all risks to people had been assessed.

The Mental Capacity Act 2005 (MCA) sets out what must be done to make sure that the human rights of people who may lack mental capacity to make decisions are protected, including when balancing autonomy and protection in relation to consent or refusal of care. The associated safeguards to the Act require providers to submit applications to a ‘Supervisory Body’ for authority to deprive someone of their liberty. We looked at whether the service was applying the safeguards appropriately. The registered manager and staff we spoke with understood the principles of the MCA and associated safeguards. They understood the importance of making decisions for people using formal legal safeguards but some improvements were needed to protect the legal and civil rights of people using the service.

People told us they were supported to eat and drink sufficient amounts to maintain their health but we found systems to monitor that people were getting enough to drink needed improvement. Risks to people’s nutrition were minimised because staff understood the importance of offering appetising meals that were suitable for people’s individual dietary needs. People had access to healthcare professionals when this was required.

We observed positive interaction between staff and people who used the service and saw people were relaxed with staff and confident to approach them for support. It was evident from the staff we spoke with that they knew the people who used the service well and had learned their likes and dislikes. Staff told us they felt supported and received regular supervision. There were some gaps in the training that staff had received and we were informed that action was being taken to address this.

People who lived at the home, their relatives and staff were encouraged to share their opinions about the quality of the service. We saw that the provider had a system in place for dealing with people’s concerns and complaints.

We found that whilst there were systems in place to monitor and improve the quality of the service provided, these were not always effective in ensuring the home was consistently well led. We found that some improvements were needed. The provider was not using the Code of Practice on the prevention and control of infections issued by the Department of Health. This sets out what care services need to do to ensure good infection control procedures are in place.

13 August 2014

During a routine inspection

This inspection was completed by one inspector. On the day of our inspection we found that nine people used the service. Due to their complex needs or health conditions, we were not able to speak with all of the people who used the service. We observed their experiences of care to inform our inspection. We spoke with two people who used the service, one relative, the registered manager and four care staff.

Below is a summary of what we found. The summary describes what people told us, what we observed, the records we looked at and what staff told us. We used the evidence we collected during our inspection to answer five questions. If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

People told us they felt safe. One person told us, "I feel safe here." Safeguarding procedures were in place and staff understood their role in safeguarding the people they supported. Staff were aware of the provider's whistleblowing policy. We found some safeguarding alerts had been made for people and the appropriate action taken by the provider. However, we found people had been deprived of their liberty without appropriate safeguarding measures in place to protect their rights.

People had not always been cared for and supported in line with their individual care plan and risk assessment. This meant that people's welfare and safety was not always protected.

We found people were not protected against the risks associated with the administration of medicines because the provider did not have appropriate measures in place.

We found the provider did not employ sufficient numbers of appropriately skilled and experienced staff to meet people's needs.

Systems were not in place to make sure that the manager and staff learned from events such as accidents and incidents, complaints and checks made on the service. This increased the risk to people.

We found people were not protected against the risks of unsafe care because the care records for people were not accurate or up to date.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. We found people had been deprived of their liberty without appropriate authority and safeguards.

Is the service effective?

We found that care plans and risk assessments were not sufficiently detailed to ensure people received appropriate care. This meant people were not receiving effective care that met their needs.

Is the service caring?

People were supported by kind and caring staff. We saw staff were patient with people. One person told us, "The staff are nice."

People's preferences, interests and diverse needs had been recorded, however care was not always provided in accordance with people's wishes.

Is the service responsive?

People were not given the opportunity to plan and engage in a range of different activities each day.

People were not asked their views about the service. When people had raised concerns the provider had not responded. One person told us, "I have complained but I feel like they don't listen to me."

Is the service well led?

The provider had risk management systems in place. We found the provider did not check that risks were managed effectively.

We found records relating to people's care lacked sufficient detail. Some records such as audits were not available and could not be located.

8 October 2013

During a routine inspection

When we visited Brook House, there were eight people staying there. During our visit, we spoke with five people at the home. They told us that they liked staying there. One person told us, 'The staff are all alright.' Another person told us, 'The staff are all nice, I've no problems with any of them.'

Throughout the inspection, we found that staff treated people with respect and supported them in a friendly, engaging manner.

We found that care and support was not always planned and delivered in a way that ensured people's safety and welfare.

People living at the home told us they felt safe and were able to raise any concerns they had.

Improvements were needed to ensure there were enough staff available at all times to meet people's needs.

The provider did not have an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who use the service and others.

At the time of our inspection the provider did not have a registered manager in post

6 December 2012

During an inspection looking at part of the service

The focus of our visit was to follow up the improvements required on systems for record keeping, identified as needed from our inspection in September 2012.

At this visit we found that improvements in the service had been made, so that the quality and availability of records supported the delivery of safe and effective care.

We met and spoke with three people who were staying at the home during our visit. People told us they were happy at the home but their feedback did not relate to record keeping.

16 August 2012

During a routine inspection

When we visited Brook House, there were four people staying there. One person went out shortly after we arrived. Other people staying at the home were unable to communicate their views of the service due to their level of learning disability and communication needs.

We used a number of different methods to help us understand the experience of people using the service. During our visit, we spoke with one person at the home. They told us that they liked staying there. Throughout the inspection, we found that staff treated people with respect and supported them in a friendly, engaging manner.

After our visit, we spoke with four relatives of people who used Brook House for respite care. Every one we spoke with was complimentary about the home. Relatives told us that they were satisfied with the care provided. One relative told us 'He laughs and is always happy to go to Brook House when I tell him he is going on respite.'

Relatives of people using the service told us that they were consulted about people's care plans and that staff regularly contacted them to check if people's needs had changed. One relative told us they were involved in review meetings and that they were frequently contacted by a member of staff at Brook House and asked to provide further information about the person's needs.

Relatives told us that they frequently received questionnaires from Brook House asking them for feedback in relation to any concerns, complaints or comments they wished to make. All of the relatives felt that they could raise concerns with the staff and management at Brook House if this was necessary and had every confidence that their views would be listened to.

29 March 2012

During a routine inspection

Brook House is a service that provides emergency care and short term breaks for people who have a learning disability. Seven people were staying at the home when we visited, we spoke with three of them. Some people were out on activities and some people were not able to communicate their views of the home.

During our visit we found that care workers treated people with dignity and respect. Care workers were kind and caring in their approach and supported people in a sensitive and respectful manner.

We found that regular meetings were held with people staying at the home. People had talked about the things that were important to them, this included the meals and activities at the home. One person told us 'I gets asked what I think about things.'

People's care plans had information about how they needed to be supported and included details of their personal preferences. Care workers that we spoke to, had a good understanding of people's individual needs. We found that one person's care plan lacked detail about the care they needed and some potential risks had not been assessed.

We asked people if they felt safe living at the home. They all confirmed that they felt Brook House was a safe place to live. We found that people had been told about the complaints procedure at resident meetings. One person told us ' I would be able to tell staff if I had a complaint.'

There were enough staff on duty to meet people's needs and we did not see anyone having to wait for assistance. People who were staying at the home told us that there were enough staff. People told us 'Staff are nice' and ' There are enough staff to help me.'

People who lived at the home and their relatives had recently been given surveys to complete, asking them about their views of the service provided. We were told that once all of the surveys had been returned an analysis would be completed of where improvements were needed. We were told that an action plan would then be completed about how the improvements would be achieved.